Individual provider Active NPI

Nell V Blake, DPM

  • Podiatrist
  • Hershey, PA
National Provider Identifier
1336103183
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC004330R Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(800) 233-4082
NPI assigned
Apr 17, 2006
Last updated
Sep 18, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC004330R PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

PO Box 854
MC A410
Hershey, PA 17033-0854
Phone (800) 233-4082

Other identifiers 1

IdentifierTypeStateIssuer
0016592660007MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101005000088 PA Practitioner - Podiatry 5799977153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

500 Universidy Dr
Hershey, PA 17033-2360
Phone (717) 531-8395

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue364
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC004330RPAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Nov 1, 2002 Accepting new patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Nov 1, 2002 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1336103183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 854",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330854",
            "telephone_number": "800-233-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "800-233-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "NELL",
        "middle_name": "V",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC004330R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016592660007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.